摘要
目的探讨盆腔调强放疗联合化疗治疗高危子宫内膜癌患者的临床疗效及对血清甲壳质酶蛋白40(YKL-40)、人附睾蛋白4(HE4)和催乳激素(PRL)的影响。方法选取2012年7月至2015年7月间暨南大学第二临床医学院收治的94例子宫内膜癌患者,采用随机数表法分为观察组50例和对照组44例。两组患者术后均采用紫杉醇+卡铂(TC方案)化疗,观察组患者在此基础上采用调强放疗,对照组患者采用三维适形放疗。比较两组患者治疗前后血清YKL-40、HE4和PRL变化情况、不良反应发生率、3年复发率及致死率。结果治疗后,两组患者血清YKL-40、HE4和PRL均低于治疗前,差异均有统计学意义(均P <0. 05),但组间比较,差异无统计学意义(P> 0. 05)。两组患者治疗期间骨髓抑制发生率比较,差异无统计学意义(P> 0. 05),观察组患者放射性肠炎和放射性膀胱炎发生率均低于对照组,差异均有统计学意义(均P <0. 05)。对照组患者失访4例,观察组患者失访6例,随访期间,两组患者复发率和致死率比较,差异均无统计学意义(均P> 0. 05)。结论高危子宫内膜癌患者采用盆腔调强放疗联合化疗治疗,效果较好,急性照射性损伤更小,安全性更高。YKL-40、HE4和PRL可成为子宫内膜癌放化疗疗效预测指标。
Objective To study the curative efficacy of pelvic intensity-modulated radiation therapy combined with chemotherapy in treatment of high-risk endometrial carcinoma and effects on serum chitinase40(YKL-40),human epididymal protein 4(HE4)and prolactin(PRL)levels.Methods A total of 94 patients with high-risk endometrial carcinoma who received therapy from July 2012 to July 2015 at Jinan University No.2 Clinical Medicine School were selected as research subjects.They were divided into an observation group(50 patients)and a control group(44 patients)by random number table method.The observation group was given intensity modulated radiotherapy on the basis of paclitaxel+carboplatin(TC regimen)and the control group was given 3 D-conformal radiotherapy.The changes of serum YKL-40,HE4 and PRL,adverse reactions,3-year recurrence rate and mortality rate were compared between the two groups.Results The serum YKL-40,HE4 and PRL were significantly lower in the two groups than those before the treatment(all P<0.05),but there was no significant difference between the two groups after treatment(P>0.05).There was no significant difference in the incidence of myelosuppression between the two groups during treatment(P>0.05).The incidence of radiation enteritis and radiation cystitis was significantly lower in the observation group than that in the control group(P<0.05).During the follow-up period,4 patients dropout in the control group and 6 dropout in the observation group,and there was no significant difference in recurrence rate and mortality between the two groups(P>0.05).Conclusion Pelvic intensity-modulated radiation therapy combined with chemotherapy is efficient for high-risk endometrial carcinoma,and compared with 3 D-conformal radiotherapy,intensity-modulated radiation therapy has less acute radiation damage and higher safety.YKL-40,HE4 and PRL can be used as the factors in predicting the efficacy of chemotherapy in patients with endometrial cancer.
作者
周亚燕
方敏捷
龚龙
李壮玲
杨东
徐钢
李先明
ZHOU Ya-yan;FANG Min-jie;GONG Long;LI Zhuang-ling;YANG Dong;XU Gang;LI Xian-ming(Department of Radiotherapy Oncology,Renmin Hospital,Jinan University No.2 Clinical Medicine School/People's Hospital of Shenzhen,Shenzhen 518000,China)
出处
《中国肿瘤临床与康复》
2019年第4期421-424,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
基金
深圳市卫生计生系统科研项目(SZFZ2018018)
关键词
高危子宫内膜肿瘤
药物疗法
盆腔调强放疗
甲壳质酶蛋白40
人附睾蛋白4
催乳激素
High-risk endometrial neoplasms
Chemotherapy
Pelvic intensity-modulated radiation therapy
Chitinase 40
Human epididymal protein 4
Prolactin
